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High Blood Pressure

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Introduction

High blood pressure or hypertension is one of the most common disorders of the modern era. It is estimated that nearly one billion people are affected by hypertension worldwide, and this figure is predicted to increase to 1.5 billion by 2025. One of the main causes of hypertension is believed to be sedentary and high-stress lifestyles associated with modern living conditions. High blood pressure is defined as persistently elevated blood pressure levels (normal range: Systolic 90.119 mm Hg; diastolic 60.79 mm Hg). Chronically elevated blood pressure levels can lead to strokes, heart attacks, heart failure and, and kidney failure. Causes of hypertension are classified as either essential or secondary. Essential hypertension refers to an increase in the blood pressure without any known reasons, whereas secondary hypertension refers to a rise in the blood pressure due to abnormality of other organs in the body (eg, kidney tumour, adrenal cancer, etc.).

Signs and symptoms of high blood pressure

Individuals with mild-to-moderate hypertension may not have any symptoms suggestive of elevated blood pressure. However, patients with severe hypertension may experience episodes of headache. Hypertensive headaches are localised to the back of the head and usually occur in the morning hours. Some individuals may also experience dizziness, palpitations, easy fatiguability and impotence with elevated blood pressure levels.

Complications of hypertension

High blood pressure can lead to narrowing and hardening of blood vessels; thereby affecting essential organs such as heart, kidney, eyes and brain. Therefore, constantly elevated blood pressure may cause heart attack, kidney failure, disease of the eyes (such as hypertensive retinopathy) and stroke.

Diagnosis of hypertension

At the initial assessment doctors may perform a complete history and physical examination of the patients. As hypertension is defined as persistently elevated blood pressure levels, three separate blood pressure measurements, at least 1 week apart, are required to confirm the diagnosis of hypertension. The exception to this is the presence of extremely high blood pressure or end-organ damage, in which case diagnosis is made and treatment is initiated immediately

Prevention and treatment of hypertension

Lifestyle changes can help in preventing high blood pressure, particularly, in people with unavoidable risk factors, such as family history of hypertension, age, race, etc.
Lifestyle changes include:

• Maintaining healthy weight
• Taking low-salt diet
• Maintaining active lifestyle or exercising
• Limiting alcohol consumption
• Stopping smoking
• Reducing stress
• Eating healthy diet

Once hypertension is diagnosed the treatment involves a combination antihypertensive medications and lifestyle modification. Treatment is essential to control high blood pressure, particularly in individuals who are at increased risk for heart disease and stroke. Lifestyle changes in addition to prescribed medications help in better management of blood pressure levels. Good blood pressure for a prolonged period of time may even help in reducing the amount of medication. Thus lifestyle modification forms an integral part of hypertension management.

Key points

• The main cause of hypertension is sedentary and high-stress lifestyles
• Constantly elevated blood pressure levels can lead to strokes, heart attacks, heart failure and arterial aneurysm, and renal failure
• Individuals with mild-to-moderate hypertension may not have any symptoms suggestive of elevated blood pressure
• Three separate blood pressure measurements, at least 1 week apart, are required to confirm the diagnosis of hypertension
• Treatment is essential to control high blood pressure, particularly in individuals who are at increased risk for heart disease and stroke
• Lifestyle modification forms an integral part of hypertension management